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Mental Health Bill [HL]

I have a good deal of sympathy with the sentiments behind this group of amendments. Certainly no one seriously involved in this area can be opposed to the production of care plans and a care planning approach. I would be the last person to oppose them. But speaking more as a former director of social services than as a former Minister, I have considerable doubts about enshrining this approach in legislation as these amendments seek to do. I recognise that the 2004 draft Bill provided for a care plan that related to compulsory treatments under the Act. Personally, I am not convinced that that was a wise route to take and I am glad that the Government have decided to change course. In my view, care planning for people with mental disorders needs to cover both health and social care needs and not be restricted just to the compulsory treatment elements. I remain somewhat sceptical, as a former manager, of how much operational sense it makes to provide for this in legislation. It is a matter for guidance, training and codes of practice, and it is certainly one to be emphasised in national service frameworks. Alongside this, if you are trying to manage a good service, you would use staff appraisal and performance management techniques to drive up quality. For some of us who have managed in this area, these approaches are likely to be more effective than crafting words in legislation. The bad news is that passing legislation which tries to change behaviour in professionals does not always achieve its objectives, and there are tomes of evidence to show this. In any case, what constitutes good care planning is itself likely to change. What we say about this area today is very different from what we would have said in 1983. That is why I think these are very much matters for guidance and training. I do not delude myself that all is right in the world in this particular area of care planning. It is right that the Government are conducting a review of the care planning approach and have been seeking views on it. That is the right approach. I find myself therefore strongly supporting the view of the joint scrutiny committee in its report that the care planning approach is important and needs to be comprehensive, but is not something to be enshrined in law. I sympathise with the views expressed by the noble Baroness, Lady Barker. As I understood her point, the code of practice is not quite up to snuff in this area. It might be wise if the Government thought a little more carefully about how they deal with the care planning approach in the code of practice and in guidance. I suspect that that is what they would do after completing this review, for that seems the appropriate way to deal with this important subject, rather than enshrining it in legislation.